تأثیر یک دوره برنامۀ توانبخشی ورزشی جامع بر سطوح نروترفین-3 مردان بیمار مبتلا به مولتیپل اسکلروزیس با سطوح مختلف ناتوانی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار فیزیولوژی ورزشی، گروه علوم ورزشی، دانشکدة ادبیات و علوم انسانی، دانشگاه ولی‌عصر (عج)، رفسنجان، ایران

2 کارشناسی ارشد، گروه فیزیولوژی ورزشی، دانشکدة ادبیات و علوم انسانی، دانشگاه آزاد اسلامی، کرمان، ایران

3 استادیار فیزیولوژی ورزشی، گروه علوم ورزشی، دانشکدة ادبیات و علوم انسانی، دانشگاه ولی‌عصر (عج)، رفسنجان، ایران

چکیده

 
مولتیپل اسکلروزیس (MS) یک بیماری مزمن و ناتوان‌کنندۀ سیستم عصبی است که میلین سیستم اعصاب مرکزی را تخریب می‌کند. هدف این تحقیق بررسی تأثیر یک دوره برنامۀ توانبخشی ورزشی بر سطوح نروتروفین-3 (NT-3) بیماران مبتلا به MS با سطوح مختلف ناتوانی است. بدین‌منظور 96 بیمار مبتلا به MS انتخاب و براساس نمرۀ مقیاس ناتوانی جسمانی به سه گروه 44=A1 (نمرة کمتر از 5/4)، 26=A2 (نمرۀ بین 5 تا 5/6) و 26=A3 (نمره 5/6 به بالا) تقسیم شدند. سپس هر کدام از گروه‌ها به‌طور تصادفی به دو زیرگروه مساوی کنترل و تجربی تقسیم شدند که در مجموع سه زیرگروه تجربی و سه زیرگروه کنترل ایجاد شد. گروه‌های تجربی جلسه‌ای یک ساعت، 3 جلسه در هفته و به مدت 12 هفته تمرینات منتخب (برنامة تمرینی پیلاتس، کششی PNF، هوازی و قدرتی) را اجرا کردند. گروه­های کنترل تنها تمرینات کششی انجام دادند. عوامل ترکیب بدنی و سطوح NT-3 قبل و بعد از تمرینات اندازه‌گیری شد. سطح معنا‌داری 05/0˂P درنظر گرفته شد. نتایج آزمون ANCOVA نشان داد که اگرچه بین سطوح NT-3 زیرگروه تجربی و کنترل گروه A3 تفاوت معنا‌داری مشاهده شد، بین زیرگروه‌های تجربی و کنترل گروه‌های A1وA2 تفاوت معنا‌داری مشاهده نشد. همچنین نتایج حاکی از وجود تفاوت معنا‌دار بین گروه‌های تجربی و کنترل در عوامل درصد چربی و شاخص تودة بدنی بود. براساس یافته‌های تحقیق حاضر می‌توان گفت که احتمالاً تمرینات ورزشی منتخب می‌توانند علاوه‌بر بهبود وضعیت ترکیب بدنی بیماران MS، موجب افزایش سطوح NT-3 و بهبود شکل‌پذیری سیستم عصبی مرکزی و بازسازی نخاع و عضله این بیماران شوند.  

کلیدواژه‌ها

عنوان مقاله [English]

The Effect of a Comprehensive Exercise Rehabilitation program on the Levels of Neurotrophin-3 in Men with Multiple Sclerosis with Different Levels of Disability

نویسندگان [English]

  • Abdolreza Kazemi 1
  • Reza Torkzadeh 2
  • Iman Fathi 3
1 Associate Professor of Exercise Physiology, Department of Physical Education, Faculty of Literature and Humanities, Vali-E-Asr University, Rafsanjan, Iran.
2 MSc, Department of Exercise Physiology, Faculty of Literature and Humanities, Islamic Azad University, Kerman , Iran
3 Assistant Professor of Exercise Physiology, Department of Physical Education, Faculty of Literature and Humanities, Vali-E-Asr University, Rafsanjan, Iran.
چکیده [English]

 
Multiple sclerosis (MS) is a chronic and debilitating disease of the nervous system that destroys myelin in the central nervous system. The aim of this study was to investigate the effect of a program of exercise rehabilitation on the Neutrophin-3 (NT-3) levels in multiple sclerosis patients with different levels of disability. 96 MS patients were selected and were divided into three groups: A1 = 44 (score less than 4.5), A2 = 26 (score between 5 and 6.5) and A3 = 26 (score above 6.5) based on their physical disability scale scores. Then, each group was divided into equal experimental and control subgroups; three experimental subgroups and three control subgroups were created. Experimental groups performed selected exercises (Pilates training, PNF stretching, aerobic and strength training) one hour per session, three sessions per week and 12 weeks. Control groups had only stretching exercises. Body composition factors and NT-3 levels were measured before and after the exercises. The significance level was considered to be P<0.05. ANCOVA test results showed that although there was a significant difference in the NT-3 levels between the experimental and control subgroups of A3 group, there was no significant difference between the experimental and control subgroups of A1 and A2 groups. Also, the results showed a significant difference between experimental and control groups in fat percentage and body mass index. Based on the findings of the present study, it can be suggested that the selected exercises may not only increase NT-3 levels and improve the plasticity of the central nervous system and reconstruct spinal cord and muscle in MS patients but also improve the body composition of these patients.

کلیدواژه‌ها [English]

  • Rehabilitation
  • MS
  • Exercise
  • NT-3
  • Disability

مراجع

1.         Niccolini F, Su P, Politis M. PET in multiple sclerosis. Clinical nuclear medicine. 2015;40(1):e46-e52.
2.         Murray J. Prelude to the framing of a disease: multiple sclerosis in the period before Charcots Leçons. 2004.
3. Masoodi R, Mohammadi E, Nabavi S, Ahmadi F. The effect of Orem based self-care program on physical quality of life in multiple sclerosis patients. J Shahrekord Univ Med Sci. 2008; 10 (2) :21-29. {In Persian}
4.         Amcconell E. Myths & facts, nursing education. Philadelphia: Lippincott Company; 1999.
5.         Eftekhari E, Nikbakht H, RABIEI K, Etemadifar M. Effect of endurance training on aerobic power and quality of life in female patients with multiple sclerosis. 2008. {In Persian}
6.         Poser C. The diagnosis and management of multiple sclerosis. Acta neurologica scandinavica. 2005;112(3):199-201.
7.         Rousseaux M, Pérennou D. Comfort care in severely disabled multiple sclerosis patients. Journal of the neurological sciences. 2004;222(1-2):39-48.
8.         Amatya B, Khan F, La Mantia L, Demetrios M, Wade DT. Non pharmacological interventions for spasticity in multiple sclerosis. Cochrane database of systematic reviews. 2013(2).
9.         Neill J, Belan I, Ried K. Effectiveness of non‐pharmacological interventions for fatigue in adults with multiple sclerosis, rheumatoid arthritis, or systemic lupus erythematosus: a systematic review. Journal of advanced nursing. 2006;56(6):617-35.
10.       Mallik M, Hall C, Howard D. Nursing knowledge & practice: Bailliere Tindall; 1998.
11.       Sosnoff JJ, Socie MJ, Boes MK, Sandroff BM, Pula JH, Suh Y, et al. Mobility, balance and falls in persons with multiple sclerosis. PloS one. 2011;6(11):e28021.
12.       Freeman J, Fox E, Gear M, Hough A. Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial. BMC neurology. 2012;12(1):19.
13.       Kokaia Z, Zhao Q, Kokaia M, Elmér E, Metsis M, Smith M-L, et al. Regulation of brain-derived neurotrophic factor gene expression after transient middle cerebral artery occlusion with and without brain damage. Experimental neurology. 1995;136(1):73-88.
14.       Chung J-Y, Kim M-W, Bang M-S, Kim M. Increased expression of neurotrophin 4 following focal cerebral ischemia in adult rat brain with treadmill exercise. PloS one. 2013;8(3).
15.       Chung J-Y, Kim M-W, Bang M-S, Kim M. The effect of exercise on trkA in the contralateral hemisphere of the ischemic rat brain. Brain research. 2010;1353:187-93.
16.       Persson H, Ibáñez CF. Role and expression of neurotrophins and the trk family of tyrosine kinase receptors in neural growth and rescue after injury. Current opinion in neurology and neurosurgery. 1993;6(1):11-8.
17.       Chung J-Y, Kim M-W, Im W, Hwang IK, Bang M-S, Kim M. Expression of neurotrophin-3 and trkC following focal cerebral ischemia in adult rat brain with treadmill exercise. BioMed research international. 2017;2017.
18.       Calcutt NA, Jolivalt CG, Fernyhough P. Growth factors as therapeutics for diabetic neuropathy. Current drug targets. 2008;9(1):47-59.
19.       Chen Y-W, Li Y-T, Chen YC, Li Z-Y, Hung C-H. Exercise training attenuates neuropathic pain and cytokine expression after chronic constriction injury of rat sciatic nerve. Anesthesia & Analgesia. 2012;114(6):1330-7.
20.       Rahmati M, Gharakhanlou R, Movahedin M, Mowla SJ, Khazani A, Fouladvand M, et al. Treadmill Training Modifies KIF5B Moter Protein in the STZ-induced Diabetic Rat Spinal Cord and Sciatic Nerve. Archives of Iranian Medicine (AIM). 2015;18(2). {In Persian}
21.       Swinnen E, Beckwée D, Pinte D, Meeusen R, Baeyens J-P, Kerckhofs E. Treadmill training in multiple sclerosis: can body weight support or robot assistance provide added value? A systematic review. Multiple sclerosis international. 2012;2012.
22.       Bronner G, Elran E, Golomb J, Korczyn A. Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention. Acta Neurologica Scandinavica. 2010;121(5):289-301.
23.       Ying Z, Roy RR, Edgerton VR, Gomez-Pinilla F. Voluntary exercise increases neurotrophin-3 and its receptor TrkC in the spinal cord. Brain research. 2003;987(1):93-9.
24.       Calcutt NA. Modeling diabetic sensory neuropathy in rats. Pain Research: Springer; 2004. p. 55-65.
25.       Stagg NJ, Mata HP, Ibrahim MM, Henriksen EJ, Porreca F, Vanderah TW, et al. Regular exercise reverses sensory hypersensitivity in a rat neuropathic pain modelrole of endogenous opioids. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2011;114(4):940-8.
26.       Gómez-Pinilla F, Ying Z, Roy RR, Molteni R, Edgerton VR. Voluntary exercise induces a BDNF-mediated mechanism that promotes neuroplasticity. Journal of neurophysiology. 2002;88(5):2187-95.
27.       Salehi I, Farajnia S, Mohammadi M, Sabouri Ghannad M. The pattern of brain-derived neurotrophic factor gene expression in the hippocampus of diabetic rats. Iranian Journal of Basic Medical Sciences. 2010;13(3):146-53. {In Persian}
28.       Copray J, Brouwer N. Selective expression of neurotrophin-3 messenger RNA in muscle spindles of the rat. Neuroscience. 1994;63(4):1125-35.
29.       Mendell LM, Johnson RD, Munson JB. Neurotrophin modulation of the monosynaptic reflex after peripheral nerve transection. Journal of Neuroscience. 1999;19(8):3162-70.
30.       Lee SS, Yoo JH, Kang S, Woo JH, Shin KO, Kim KB, et al. The effects of 12 weeks regular aerobic exercise on brain-derived neurotrophic factor and inflammatory factors in juvenile obesity and type 2 diabetes mellitus. Journal of physical therapy science. 2014;26(8):1199-204.
31.       Zochodne D, Ramji N, Toth C. Neuronal targeting in diabetes mellitus: a story of sensory neurons and motor neurons. The Neuroscientist. 2008;14(4):311-8.
32.       Sharma NK, Ryals JM, Gajewski BJ, Wright DE. Aerobic exercise alters analgesia and neurotrophin-3 synthesis in an animal model of chronic widespread pain. Physical therapy. 2010;90(5):714-25.
33.       Rossi DM, Valenti VE, Navega MT. Exercise training attenuates acute hyperalgesia in streptozotocin-induced diabetic female rats. Clinics. 2011;66(9):1615-9.
34.       Fernyhough P, Diemel LT, Brewster WJ, Tomlinson DR. Altered neurotrophin mRNA levels in peripheral nerve and skeletal muscle of experimentally diabetic rats. Journal of neurochemistry. 1995;64(3):1231-7.
پژوهش های فیزیولوژی و مدیریت در ورزش
دوره 12، شماره 2
شهریور 1399
صفحه 157-167

فایل ها

هم رسانی

ارجاع به این مقاله

آمار